- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $27,542.29 / $45,708.82
| Facility | | $13,182.57 | $27,542.29 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $25,118.86 / $67,608.30
| Facility | | $6,165.95 | $25,118.86 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $26,302.68 / $38,904.51
| Facility | | $15,488.17 | $26,302.68 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,018.94 / $38,018.94 / $38,018.94
| Facility | | $38,018.94 | $38,018.94 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $24,547.09 / $67,608.30
| Facility | | $6,165.95 | $24,547.09 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $25,118.86 / $67,608.30
| Facility | | $6,165.95 | $25,118.86 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $20,417.38 / $58,884.37
| Facility | | $6,165.95 | $20,417.38 | $58,884.37 |